Data Management and Health System Strengthening in Nigeria
One of the World Health Organization’s six building blocks of effective health strengthening is the Health Information System (WHO, 2019). Health Information Systems (HIS) serve multiple users and a wide array of purposes that can be summarized as the "generation of information to enable decision-makers at all levels of the health system to identify problems and needs, make evidence-based decisions on health policy and allocate scarce resources optimally" (WHO, 2023). The lack of robust and effective HIS often results in a significant gap between what policy-makers, health professionals, and researchers know and what they need to know to improve the population's health. Data from different sources, including health facilities, population-based surveys, and civil registration and vital statistics systems, can easily be modified or expanded to meet the informational needs of the health system.
Effective data management is crucial for strengthening the health system in Nigeria. Nigeria, the most populous country in Africa, has a high disease burden, with challenges such as infectious diseases, non-communicable diseases, and maternal and child health issues (WHO, 2021). However, data availability, quality, and use are often problematic in Nigeria. Challenges highlighted by some studies in Nigeria on data quality include poor data quality, incomplete data, inconsistencies in data reporting, and untimely data submission. One of the factors propelling this problem is the reliance on manual methods of inputting data. Concerning this, the need for functional well-led automated health data management has been advocated to strengthen the health system (Welcome, 2011). Meeting this is often challenging due to low manpower workforce, infrastructures, inadequate financing mechanisms, inadequate political will, and poor knowledge of computers and information technology for health recording. In this context, the importance of data management should be emphasized.
Here are some reasons why effective data management is essential to strengthening the health system in Nigeria:
Improved decision-making: Firstly, effective data management helps to identify and address health system gaps and challenges. Accurate and reliable data on disease burden, health outcomes, and health services utilization can help health planners and policymakers make informed decisions about resource allocation, planning, service delivery, what interventions are needed, and where to target interventions. For instance, data on high maternal and child mortality rates can help policymakers prioritize interventions to improve maternal and child health. Effective data management ensures the correct data is available to decision-makers when needed.
Better tracking and Surveillance of disease trends: good surveillance is the cornerstone of effective communicable disease control. Without it, tracking disease trends, recognizing new disease threats, identifying severe outbreaks, monitoring control measures, and designing effective immunization policies is impossible. Once a significant epidemic occurs, it is vital to have a data management system that supports efficient data capture and information flow and can provide a master list of up-to-date case-based information in real-time (CDC, 2018). Effective data management can help track health trends over time, allowing for better planning and prevention of outbreaks of diseases. This is particularly important in Nigeria, where malaria, HIV/AIDS, Tuberculosis, and Lassa Fever are prevalent.
Increased Monitoring, Evaluation, and Accountability: Effective data management helps to monitor and evaluate health programs and interventions. Regular M and E of health programs ensure they meet their objectives and produce desired outcomes. Proper data management systems can help track the progress of health programs and identify areas where improvements are needed. Similarly, with accurate data, it is easier to track progress and measure the impact of interventions. This can help identify areas where modifications are required and hold people accountable for their actions in achieving results.
Improved patient care: effective data management helps to improve patient care and outcomes. Electronic health records (EHRs) can improve the quality of patient care by providing accurate and complete medical histories, facilitating communication among healthcare providers, and reducing medical errors. EHRs can also help healthcare providers make informed decisions about patient care and treatment by providing real-time access to patient data. However, despite the potential benefits of EHRs, their adoption and use have been slow in the Nigerian healthcare system as clinicians depend on patients keeping their records manually with no centralized database to manage and control patients’ medical history.
Timely and effective data collection is the first step to providing enhanced databases for healthcare systems and management. Therefore, Nigeria’s health system needs to strengthen its data collection systems to ensure that data is collected promptly and accurately. This can be achieved by deploying and using EHRs, which can help reduce the burden of paper-based systems.
There is a need for the regular training and monitoring of data collectors, biostatisticians, and epidemiologists in health systems and private and government institutions to improve the quality of health data in Nigeria. Also, the government needs to invest in data analytics to make better use of the data collected. This can help identify trends and patterns in health data, informing policy decisions and improving health outcomes.
Data privacy and security should be a priority in Nigeria’s health system to protect patient information. Policies should be implemented to ensure that data is only accessed by authorized personnel and that data breaches are reported and addressed. There is a need to increase public awareness of the importance of data management. This can be achieved through health education campaigns and information to the Nigerian populace.
Effective data management is essential for strengthening the health systems in Nigeria. It can help identify and address health system gaps and challenges, improve decision-making, monitor and evaluate health programs, and improve patient care and outcomes. Therefore, Nigeria must invest in building robust data management systems to ensure that health data is accurately collected, managed, and utilized to improve the health of its population.
Centers for Disease Prevention and Control (2018). Using Technologies for Data Collection and Management. Available at: https://www.cdc.gov/eis/field-epi-manual/chapters/data-collection-management.html Accessed 19 April 2023
Welcome, M.O. (2011). The Nigerian health care system: Need for integrating adequate medical intelligence and surveillance systems. J Pharm Bio allied Sci. 2011 Oct;3(4):470-8. https://doi.org/10.4103/0975-7406.90100
World Health Organization (2021). Nigeria 2021 Annual Report-Making People Healthier. https://www.afro.who.int/sites/default/files/2022-08/WHO%20Nigeria%202021%20annual%20report_single%20paged.pdf
World Health Organization (2023). Health Information System. Available at: https://www.who.int/activities/integrating-rehabilitation-into-health-systems/information
World Health Organization (2019). Recommendations on Digital Interventions for Health System Strengthening. Available at: https://apps.who.int/iris/bitstream/handle/10665/311941/9789241550505-eng.pdf?ua=1